Evaluation of Lactation Compatibility Reference Recommendations

Abstract

Background: Multiple resources aid the interprofessional health care team when recommending medications for lactating patients. Varying degrees of breastfeeding compatibility and safety are recommended in different resources. New Food and Drug Administration labeling for lactation is being phased in to provide more consistent language in safety recommendations. Objective: The objective of this study is to evaluate lactation recommendations for select medications from different drug information resources to determine the compatibility recommendations for lactating patients. Methods: The breastfeeding recommendations for 19 medications were analyzed in 10 drug information resources. Each drug was reviewed in each resource and the published recommendations evaluated. Results: Medications and Mothers’ Milk 18th Edition and LactMed had the most medications listed as compatible with breastfeeding, with Lexicomp Online, Drugs in Pregnancy and Lactation Online, and Epocrates following. LactMed stands out from the group with an average of 15.1 references per medication and number of references ranging from 0 to 58. Date ranges of references used by select resources varied. References to support recommendations ranged from 1979 to 2018 for the select resources. Conclusion and Relevance: Variation continues to exist across resources with regard to recommendations for medication safety in lactation. LactMed represents the most up-to-date and comprehensive review of literature in this review. When making decisions regarding medication use during lactation, health care professionals should consider reviewing data behind the recommendations and consulting multiple resources.